• Langue : Français
• Discipline : Médecine. Chirurgie générale
• Identifiant : 2018LILUM116
• Type de thèse : Doctorat de médecine
• Date de soutenance : 18/05/2018

Résumé en langue originale

Introduction : The epidemiology of cosmetic surgery is well known in the world, but less in France. According to the International Society of Aesthetic Plastic Surgery, the number of interventions has increased by 8% worldwide in 2016. These particular patients are known to have psychosocial factors, and psychiatric comorbidities (body dysmorphic disorder, personality disorders, depressive states, suicide attempt). In France, aesthetic surgery procedures are routinely collected in the PMSI database, a nationwide compulsory discharge collection, as well as all the hospital admissions of these patients. The objective of the study was to describe the outcome of patients after a first cosmetic surgery in terms of aesthetic rehospitalization or others, by data reuse of the PMSI. Materiel and Methods : Hospital inpatient stays from 2008 to 2014 were extracted from the PMSI. Two patient groups were defined: patients undergoing aesthetic surgery (group A), and patients undergoing an appendectomy randomly selected (group B). The inpatient stays of group A were analyzed, and readmission rates were compared by pairing patients from groups A & B according to age, gender, and geographic area (exact matching). Results : Over 7 years, 349,798 inpatient stays of aesthetic surgery were analyzed, corresponding to 163,517 different patients. The mean age of the patients was 43.4 years. Men were 2.3 years older than women (p=0). Bilateral augmentation mammoplasty was the most frequent procedure (23.7%), followed by liposuction (17.0%). Most of the time (67.2%), only one surgical procedure was performed per stay (two procedures in 14.6%). Patients were followed-up 0 to 7 years (2 years for 126,227 patients, and 5 years for 56,868 patients). After a first cosmetic surgery, 720,018 readmissions were observed, irrespectively from the cause. Regarding surgical nomadism, 25.7% of patients having a surgery and followed up 5 years, had surgeries in at least two different facilities. By comparing those patients to patients having appendectomy (same age, gender and region), the risk of abortion after an aesthetic surgery was significantly increased at 2 years (8.4% vs 1.1%, RR=7.5, p=0), as well as self-inflected injuries (0.64% vs 0.27%, RR=2.4, p=0), intoxications (1.9% vs 0.86%, RR=2.2, p=0), medically assisted procreation (0.83% versus 0.32%, RR 2.6, p=0), but also altruism (enrollment in research protocols and workup for the donation of organs, 0.26% vs 0.04%, RR 6.5, p=0). Conclusion : The figures of cosmetic surgery in France followed the current global trend. Aesthetic surgery patients seem to have more abortion and more suicide attempts than the general population.

Résumé traduit

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